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MR. SUPAVICH TANNUMSAENG M.D.
NPI 1669212221
Student in an Organized Health Care Education/Training Program in Greenville, NC

Active since May 30, 2024PECOS Enrolled
2100 STANTONSBURG ROAD, ECU HEALTH MEDICAL CENTER, GREENVILLE, NC 27834(252) 847-4100(252) 744-3811 Get Directions Write a Review

NPPES record last updated: September 27, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mr. Supavich Tannumsaeng M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. SUPAVICH TANNUMSAENG M.D. (NPI 1669212221) is an individual student in an organized health care education/training program in Greenville, North Carolina and active in the NPI registry since May 2024. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1669212221
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameMR. SUPAVICH TANNUMSAENGCredential: M.D.
Location Address2100 STANTONSBURG ROAD, ECU HEALTH MEDICAL CENTERGreenville, NC 27834
Mailing Address2100 Stantonsburg Road, Ecu Health Medical CenterGreenville, NC 27834 · (252) 847-4100 · Fax (252) 744-3811
Phone(252) 847-4100
Fax(252) 744-3811
Sole ProprietorNo
Enumeration DateMay 30, 2024
Last NPPES UpdateSeptember 27, 2024
✔ NPI 1669212221 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
2100 STANTONSBURG ROAD, ECU HEALTH MEDICAL CENTER, Greenville, NC 27834
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Supavich Tannumsaeng M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Supavich Tannumsaeng's NPI number?

The NPI number for Supavich Tannumsaeng is 1669212221. It was assigned to this individual provider in the NPPES registry on May 30, 2024.

Where is Supavich Tannumsaeng located?

Supavich Tannumsaeng practices at 2100 Stantonsburg Road, Ecu Health Medical Center, Greenville, NC 27834. The listed phone number is (252) 847-4100.

What is Supavich Tannumsaeng's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Supavich Tannumsaeng enrolled in Medicare?

Yes. Supavich Tannumsaeng is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Supavich Tannumsaeng was last updated on September 27, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.